CVS Health
Case Management Coordinator- Field- Salt River Trail Region KY
CVS Health, Frankfort, Kentucky, United States, 40601
Case Management Coordinator – Field – Salt River Trail Region KY
At CVS Health, we’re building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care.
As the nation’s leading health solutions company, we reach millions of Americans through our local presence, digital channels and more than 300,000 purpose-driven colleagues – caring for people where, when and how they choose in a way that is uniquely more connected, more convenient and more compassionate.
We do it all with heart, each and every day.
Position Summary Aetna Better Health is hiring for multiple openings across the state/regions of Kentucky.
The Case Management Coordinator (CMC) utilizes critical thinking and professional judgment to support the case management process, facilitating and maintaining improved health care outcomes for members.
The CMC provides advocacy, collaboration coordination, support and education for members through the use of care management tools and resources.
This is a telework position that requires regional in‑state travel 80‑90% of the time and occasional travel to the Louisville office for meetings and training.
Qualified candidates must have reliable transportation and reside in a county within the Salt River Trail Region.
Flexibility to work beyond core business hours of Monday‑Friday, 8am‑5pm EST is required.
The role primarily serves children and families who may need support after school or after work.
Evaluation Of Members
Using care management assessments and data reviews, recommend an approach to resolving care needs while maintaining optimal health and well‑being by evaluating member benefit plans and available internal and external programs and services.
Identify high‑risk factors and service needs that may impact member outcomes and implement early and proactive support interventions.
Coordinate and implement wellness care plan activities and monitor member care needs.
Enhancement Of Medical Appropriateness And Quality Of Care
Consult holistically with case managers, supervisors, Medical Directors and other health programs to overcome barriers, presenting cases at conferences for multidisciplinary review to achieve optimal outcomes.
Identify and escalates quality of care issues through established channels.
Use negotiation skills to secure appropriate options and services necessary to meet member benefits and healthcare needs.
Employ influencing and motivational interviewing skills to ensure maximum member engagement and promote lifestyle and behavior changes.
Provide coaching, information and support to empower members to make ongoing independent medical and healthy lifestyle choices.
Help members actively and knowingly participate with their provider in healthcare decision‑making.
Monitoring, Evaluation And Documentation Of Care
Utilize case management and quality management processes in compliance with regulatory and accreditation guidelines and company policies and procedures.
Required Qualifications
Minimum 6 months experience in Foster Care and juvenile justice systems, Adoption Assistance, delivery of Behavioral Health Services, Trauma‑informed Care, ACEs, Crisis Intervention services or evidence‑based practices applicable to the Kentucky SKY populations.
Minimum 2 years of experience in behavioral health, social services, social work, psychology, sociology, marriage and family therapy, or counseling.
Minimum 1 year of experience in Microsoft Office Suite applications, including Word and Excel.
Willing and able to travel 80‑90% of the time to meet members face‑to‑face in the assigned region.
Candidate must reside in one of the following counties: Breckinridge, Grayson, Meade, Hardin, Larue, Bullitt, Nelson, Marion, Washington, Spencer, Anderson, Woodford, Shelby, Franklin, Henry, Oldham, or Trimble.
Preferred Qualifications
3+ years experience in behavioral health, social services, social work, psychology, sociology, marriage and family therapy, or counseling.
1+ MCO experience.
Education
Minimum of a Bachelor’s degree or a non‑licensed master’s level clinician in behavioral health or a human services field.
Anticipated Weekly Hours 40 hours per week.
Time Type Full time.
Pay Range $21.10 – $36.78 per hour.
This range represents the base hourly rate for all positions in the job grade within which this role falls.
The actual base offer depends on experience, education, geography and other factors.
The position is eligible for a CVS Health bonus, commission or short‑term incentive program in addition to the base pay.
Great Benefits For Great People
Affordable medical plan options, a 401(k) plan (including matching company contributions), and an employee stock purchase plan.
No‑cost programs for all colleagues including wellness screenings, tobacco cessation and weight management, confidential counseling, and financial coaching.
Benefit solutions that address different needs and preferences, including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility.
For more information, visit https://jobs.cvshealth.com/us/en/benefits
We anticipate the application window for this opening will close on November 14 2025.
Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.
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As the nation’s leading health solutions company, we reach millions of Americans through our local presence, digital channels and more than 300,000 purpose-driven colleagues – caring for people where, when and how they choose in a way that is uniquely more connected, more convenient and more compassionate.
We do it all with heart, each and every day.
Position Summary Aetna Better Health is hiring for multiple openings across the state/regions of Kentucky.
The Case Management Coordinator (CMC) utilizes critical thinking and professional judgment to support the case management process, facilitating and maintaining improved health care outcomes for members.
The CMC provides advocacy, collaboration coordination, support and education for members through the use of care management tools and resources.
This is a telework position that requires regional in‑state travel 80‑90% of the time and occasional travel to the Louisville office for meetings and training.
Qualified candidates must have reliable transportation and reside in a county within the Salt River Trail Region.
Flexibility to work beyond core business hours of Monday‑Friday, 8am‑5pm EST is required.
The role primarily serves children and families who may need support after school or after work.
Evaluation Of Members
Using care management assessments and data reviews, recommend an approach to resolving care needs while maintaining optimal health and well‑being by evaluating member benefit plans and available internal and external programs and services.
Identify high‑risk factors and service needs that may impact member outcomes and implement early and proactive support interventions.
Coordinate and implement wellness care plan activities and monitor member care needs.
Enhancement Of Medical Appropriateness And Quality Of Care
Consult holistically with case managers, supervisors, Medical Directors and other health programs to overcome barriers, presenting cases at conferences for multidisciplinary review to achieve optimal outcomes.
Identify and escalates quality of care issues through established channels.
Use negotiation skills to secure appropriate options and services necessary to meet member benefits and healthcare needs.
Employ influencing and motivational interviewing skills to ensure maximum member engagement and promote lifestyle and behavior changes.
Provide coaching, information and support to empower members to make ongoing independent medical and healthy lifestyle choices.
Help members actively and knowingly participate with their provider in healthcare decision‑making.
Monitoring, Evaluation And Documentation Of Care
Utilize case management and quality management processes in compliance with regulatory and accreditation guidelines and company policies and procedures.
Required Qualifications
Minimum 6 months experience in Foster Care and juvenile justice systems, Adoption Assistance, delivery of Behavioral Health Services, Trauma‑informed Care, ACEs, Crisis Intervention services or evidence‑based practices applicable to the Kentucky SKY populations.
Minimum 2 years of experience in behavioral health, social services, social work, psychology, sociology, marriage and family therapy, or counseling.
Minimum 1 year of experience in Microsoft Office Suite applications, including Word and Excel.
Willing and able to travel 80‑90% of the time to meet members face‑to‑face in the assigned region.
Candidate must reside in one of the following counties: Breckinridge, Grayson, Meade, Hardin, Larue, Bullitt, Nelson, Marion, Washington, Spencer, Anderson, Woodford, Shelby, Franklin, Henry, Oldham, or Trimble.
Preferred Qualifications
3+ years experience in behavioral health, social services, social work, psychology, sociology, marriage and family therapy, or counseling.
1+ MCO experience.
Education
Minimum of a Bachelor’s degree or a non‑licensed master’s level clinician in behavioral health or a human services field.
Anticipated Weekly Hours 40 hours per week.
Time Type Full time.
Pay Range $21.10 – $36.78 per hour.
This range represents the base hourly rate for all positions in the job grade within which this role falls.
The actual base offer depends on experience, education, geography and other factors.
The position is eligible for a CVS Health bonus, commission or short‑term incentive program in addition to the base pay.
Great Benefits For Great People
Affordable medical plan options, a 401(k) plan (including matching company contributions), and an employee stock purchase plan.
No‑cost programs for all colleagues including wellness screenings, tobacco cessation and weight management, confidential counseling, and financial coaching.
Benefit solutions that address different needs and preferences, including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility.
For more information, visit https://jobs.cvshealth.com/us/en/benefits
We anticipate the application window for this opening will close on November 14 2025.
Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.
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